Endocrine Abstracts

Background

Similar to other patients with life-threatening medical conditions, the fear of contracting COVID-19 for Cushing Syndrome (CS) patients is a natural reaction which has created a number of urgent questions, requiring answers. These questions include: how my body will react to the virus; will my current comorbidities increase; what will happen if I don’t have my regular clinic appointments, surgery and chemotherapy treatments? What do I do if I am hospitalised and will my endocrinologist contact me to advise?

Methods

A Quality of Life (QoL) CS 2020 survey on 86 members of a support group during the onset of the pandemic accidently revealed in one of the QoL open questions, the thoughts and fears of contracting the virus. A thematic analysis was conducted on the 29 members who expressed their fears, to ascertain patterns of importance and interpret any challenges/issues which might be affecting their QoL and thus reduce their QoL scores.

Results

The analysis revealed that all 29 were fearful of contracting COVID-19 and recorded a lower QoL score than those of the other participants, (P <.001). The main reasons given were: that they may not be able to tolerate additional medications; 3 of them had been diagnosed with Addison’s disease, 8 with pulmonary, cardiovascular and inflammatory conditions and 6 with diabetes. All 29 had cancelled outpatient appointments including 1 who was awaiting chemotherapy and 16 their radiology appointments. 9 were awaiting surgery which had been postponed. 11 were disappointed that their endocrinologist had not contacted them but were glad that they belonged to a support group. 26 were already experiencing depressive illnesses as a consequence of their CS, reported that lockdown measures had made them feel isolated, depressed and in 1 case suicidal.

Conclusion

Endocrine advice and support is even more crucial during a pandemic. The fears engendered cause further challenges for these patients and undoubtedly a reduction in their QoL. This survey had identified the breakdown of social life and personal relationships due to their illness and this had led to loneliness and depression. COVID-19 is suggested in this survey, to exacerbate these, with serious long-term consequences. If support and advice are not in place, then morbidity and mortality rates may increase exponentially. It is imperative that these patients must be able to continue their diagnostic and treatment journeys in order to save their lives and further save cost for healthcare services and improve long-term patient outcomes.